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General NPI Number Information
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NPI Number | 1609267954
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Entity Type | Organization
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Legal Business Name | JOHN S. MARSHBURN, M.D., INC
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Dates
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Enumeration Date | 02/09/2015
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Last Update Date | 02/09/2015
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Provider Practice Location Address
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Address Line | 1275 N ROSE DR #112
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City | PLACENTIA
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State | CA
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Zip | 92870-3941
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Country | US
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Telephone | 714-792-1199
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Fax | 714-792-1196
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Provider Business Mailing Address
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Address Line | 1275 N ROSE DR #112
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City | PLACENTIA
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State | CA
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Zip | 92870-3941
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Country | US
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Telephone | 714-792-1199
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Fax | 714-792-1196
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. JOHN S MARSHBURN
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Credential | M.D.
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Telephone | 714-792-1199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A60789
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License Number State | CA
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